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If A Drug Is Legal It Must Be Safe, Right? Wrong.
Date:1/9/2012

WASHINGTON, Jan. 9, 2012 /PRNewswire-USNewswire/ -- Synthetic drugs, which are increasingly popular and sold in stores and over the Internet, can cause harm serious enough to warrant hospitalization. Two case reports of patients treated in emergency departments after using so-called "designer drugs" are published online today in Annals of Emergency Medicine ("Serotonin Syndrome Associated with MDPV Use: A Case Report" and "Ketamine-Like Effects After Recreational Use of Methoxetamine"). 

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"Our patient had been using a designer drug known as 'bath salts' and became so sick that she required hospitalization in the intensive care unit for 12 days," said lead study author Josh Mugele, M.D., of Indiana University School of Medicine in Indianapolis, Ind.  "The frightening thing is that she was able to buy these drugs, marketed as a novelty item called Blue Magic bath salts, from behind the counter at a gas station."

The 41-year-old patient developed serotonin syndrome, a potentially deadly reaction to drugs, after inhaling methylenedioxypyrovalerone (MDPV).  The course of her illness included pneumonia and bacteremia, which can be fatal. 

MDPV is sold as a novelty item and called bath salts, plant fertilizer or plant food. 

A related paper presents the first published case of emergency department treatment of a patient who had injected Methoxetamine, a recreational drug known by the street names MXE, M-ket, Kmax, and Mexxy.  It is sold over the Internet as a research chemical. Methoxetamine is chemically similar to ketamine, which has been scheduled as a controlled substance because of increased illicit use.  Toxic effects of the drug include vomiting, diarrhea, disorientation and the inability to speak.

The American College of Emergency Physicians supported legislation designed to curb distribution and use of synthetic drugs: H.R. 1254 (Synthetic Drug Control Act of 2011) was recently approved in the House of Representatives.  It would create a national ban on synthetic drugs, such as "bath salts," and provide the Drug Enforcement Administration with the authority to temporarily classify these substances as Schedule I drugs for up to three years. 

"These designer drugs are growing in popularity and emergency physicians are on the front lines of dealing with the fallout," said Dr. Mugele.

Annals of Emergency Medicine is the peer-reviewed scientific journal for the American College of Emergency Physicians, a national medical society. ACEP is committed to advancing emergency care through continuing education, research, and public education. Headquartered in Dallas, Texas, ACEP has 53 chapters representing each state, as well as Puerto Rico and the District of Columbia. A Government Services Chapter represents emergency physicians employed by military branches and other government agencies. For more information visit www.acep.org.

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SOURCE American College of Emergency Physicians (ACEP)
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